Subtheme Two: Unexpected Support

While several of the women described having poor expectations of service-input, many spoke to opinions changing once they received direct interventions from EI services, as presented here in subtheme, ‘Unexpected Support’. Participants’ prior encounters with mental health services, lack of access to finances, one’s social identity and status, illustrated how significant the ‘Impact of Adversity’, can shape service engagement for this particular group of women.

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Participants in these next extracts describe their thoughts on accessing care from mental health services:

Ayaan: Um...I thought maybe.. I thought at first I'm just gonna go home from hospital and stay at home. They're just gonna give me medication, stuff like that, that's what I was thinking.

Dami: I never wanted to work with mental health services in the first place - my family’s always been supportive so, I’ve always been someone that likes to do stuff on my own.

Ayaan describes thoughts that mental health teams in the community may be somewhat detached and medicalised in their approach. Dami states she had no interest in service input. She describes valuing her strong support network, as well as her own independence, as reasons to why she felt mental health provision was not required.

Later in her interview, despite initially holding seemingly negative views of mental health provision, Dami spoke positively about her experience with the EI team:

Dami: Um, I do think they do like, the best they can for people. They actually care about their patients… they do all they can.

Just as she talked favourably about the care she received, so did other participants:

Amanthi: Like, they support in every way they can. Whether it’s

psychologist, employment, benefits… So, when I came out of the psychosis, I was blank… After my dad’s death, after he passed away, things had changed. Like all the benefits and stuff that we had to sort out, was on me. And I had too much

responsibility, which I couldn’t take on my own. So they suggested to me, universal credit… I didn’t even know about universal credit! I didn’t know where to get my answers.

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Sylvia: They gave me support in like all areas of my life, you know.

First thing we got sorted was, what was it? Like getting me on the housing list, then Freedom Pass. She's helped me with so much, I can't even remember.

Participants in the extracts above, describe the EI team’s ability to support their immediate social and material needs, i.e., access to financial support and suitable accommodation, as a function of the service they highly appreciated. Amanthi describes life after hospital as a time of difficulty (“I was blank”), but alongside this speaks to previous longer term challenges in managing access to funds. It seems she found service support with this as particularly helpful. Sylvia speaks here about the help she received with accommodation, also inferring in her talk that she had lost count of how much support she had received.

Alongside the range of interventions on offer, women also described encountering caring professionals attuned to their needs:

Sabina: Care coordinator was very nice. She used to go with me to get the benefit, and with my husband in the carers' centre. This information, that information. Freedom bus pass. ALL the

information, she used to give to us… Even Psychologist, she IS so lovely, young lady. And every week, spend time with, just talking, just expression of feelings.

Christiana: Um well they supported me in like, helping me to take my medication. And, um one of them supported me with my self-confidence. ‘Cause she NOTICED that I was a very shy, person.

When she would be like talking to me, I’d be looking like down, I won’t give her eye contact. She’d be like, ‘You need to think highly of yourself, you’re fearfully and wonderfully made’. And then it just, boosted my confidence up high.

Sabina talks to feeling supported both practically and emotionally, describing how she received help not only for herself, but her husband too. Both women speak here to experiencing positive interactions with staff members. Christiana refers specifically

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to her “self-esteem” and “confidence”, describing an encouraging experience she had with a care co-ordinator.

The women also spoke to what it was like to experience this type of help from services. Many seemed to express gratitude for the unanticipated quality of support received:

Sylvia: I think it's the best thing that could've happened, after being sectioned, just to have someone who's dedicated to like working with you. And you know every week, this time or whatever, you go there, and you have a space to like, to talk about whatever's bothering you. Because of my experience with CAMHS, If I had gone to see a counsellor and she had just told me like before, 'you’ve done this to yourself', I would've just withdrawn from services… Like they knew I was on drugs. They didn't pass ANY judgement you know.

Amanthi: They’ve actually helped me out, because we don’t expect people to do things for us.

Dianne: I'm still getting used to it. Like people, supporting me... I'm used to looking after my mum and even in my friendship groups. I was like the listener for them... So, I'm not used to people being interested in what I'm doing. And they will ask me like.. do I want to go back to uni and work? And I was just, erm, I was quite flattered. That they were interested and wanted to help me. Like my care coordinator is really lovely and, I felt quite

supported. Like I'd come to a psychology appointment just to talk about myself and my difficulties, so that was weird. But that was really nice, and they guided me through it over time.

Sylvia speaks here to previous interactions with mental health services; how she felt this differed from experiences with the team now. She describes an appreciation for their non-judgemental approach. Like Dianne, Sylvia also expresses valuing a space

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to talk, focussed on her own personal adversities and needs. However, receiving such a dedicated level of help, may be experienced as a surprising and uncommon occurrence, as indicated in Dianne and Amanthi’s talk. Dianne describes how not taking up her usual role of caretaker for others, was an unusual but pleasant experience. She seems to appreciate the gradual navigation through the therapy process.

The final participant in this subtheme, also speaks to the experience of accessing psychology within an EI service:

Fahima: It took like 6 months for me to understand what a psychologist is and what I'm meant to share with her. She then helped me go forward to report the rape to the police the first time. The second time I had to do it myself - but you know, only coz my time with her and the team is finishing. It’s disappointing, coz NOW is the time I NEED a psychologist… I need all that support, whereas in the beginning I didn't use it properly, because I just didn't know how to.

Following receiving initial psychological support under the EI service, Fahima describes feeling dissatisfied with the plan of discharge. She speaks to an

awareness that her time with the team is limited, however feels it is “disappointing”

this is happening now - alluding to the current emotional impact of engaging with police to report the rape perpetrator. Similar to Dianne, who talks to the significance of time in understanding the function of psychology, Fahima speaks to a similar experience of going through a somewhat lengthy process to grasp how to utilise therapy sessions in EI services best.